Feeling the Burn?

Bet you’ve been eating rich, greasy, and spicy foods the past month or so. Maybe a few cocktails to wash it all down or some cold bubbly soda, and delicious desserts followed by coffee. It all tastes so good going down. But unfortunately, for millions of Americans, it doesn’t taste as good coming back up as acid indigestion, or heartburn.

More than 60 million American adults experience heartburn at least once a month, and more than 15 million adults suffer daily from heartburn. Many pregnant women experience daily heartburn as well. For some people, it’s just too much of a good thing, and in a day or two the indigestion is gone.  But for those suffering regularly, it’s far more insidious and upsetting, and can cause long-term damage.

Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the lower esophageal sphincter, the ring of muscle between the esophagus and stomach. In most cases, GERD can be relieved through diet and lifestyle changes; however, GERD can result in serious complications. Esophagitis can occur as a result of too much stomach acid in the esophagus. Esophagitis may cause esophageal bleeding or ulcers. In addition, a narrowing or stricture of the esophagus may occur from chronic scarring. Some people develop a condition known as Barrett’s esophagus. This condition can increase the risk of esophageal cancer.

Gastroesophageal refers to the stomach and esophagus. Reflux means to flow back or return, so gastroesophageal reflux is the return of the stomach’s contents back up into the esophagus. In normal digestion, the lower esophageal sphincter (LES) opens to allow food to pass into the stomach and closes to prevent food and acidic stomach juices from flowing back into the esophagus. Gastroesophageal reflux occurs when the LES is weak or relaxes inappropriately, allowing the stomach’s contents to flow up into the esophagus.

What is hiatal hernia?

Some doctors believe a hiatal hernia may weaken the LES and increase the risk for gastroesophageal reflux. Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the diaphragm. The diaphragm is the muscle separating the abdomen from the chest. Many people with a hiatal hernia will not have problems with heartburn or reflux. But having a hiatal hernia may allow stomach contents to reflux more easily into the esophagus.

Coughing, vomiting, straining or sudden physical exertion can cause increased pressure in the abdomen resulting in hiatal hernia. Obesity and pregnancy also contribute to this condition. Many otherwise healthy people age 50 and over have a small hiatal hernia. Although considered a condition of middle age, hiatal hernias affect people of all ages.

Hiatal hernias usually do not require treatment. However, treatment may be necessary if the hernia is in danger of becoming strangulated or twisted in a way that cuts off blood supply, or is complicated by severe GERD or esophagitis. In these cases, your doctor may perform surgery to reduce the size of the hernia or to prevent strangulation.

To help your doctor diagnose GERD or hiatal hernia, an upper GI series may be performed during the early phase of testing. This test is a special X-ray that shows the esophagus, stomach, and duodenum (the upper part of the small intestine). While an upper GI series provides limited information about possible reflux, it is used to help rule out other diagnoses, such as peptic ulcers.

Endoscopy is an important procedure for individuals with chronic GERD. By placing a small lighted tube with a tiny video camera on the end (endoscope) into the esophagus, the doctor may see inflammation or irritation of the tissue lining the esophagus, and can easily and painlessly biopsy tissue samples.

What you can do to feel better

Doctors recommend lifestyle and dietary changes for most people needing treatment for GERD. Treatment aims at decreasing the amount of reflux or reducing damage to the lining of the esophagus from refluxed materials. Other tips for reducing or controlling reflux include:

  • Avoid foods and beverages that can weaken the LES. These foods include chocolate, peppermint, fatty foods, coffee, and alcoholic beverages. Foods and beverages that can irritate a damaged esophageal lining, such as citrus fruits and juices, tomato products and pepper also should be avoided.
  • Decrease the size of portions. Eating less at mealtime may also help control symptoms.
  • Eat meals at least two to three hours before Avoid eating within a few hours of going to bed or lying down. This may lessen reflux by allowing the acid in the stomach to decrease and the stomach to empty partially.
  • Lose weight. Being overweight often worsens symptoms.
  • Stop smoking cigarettes. Cigarettesmoking weakens the LES. Stopping smoking is important to reduce GERD symptoms.
  • Elevate the head of the bed. Raising your bed on six-inch blocks or sleeping on a specially designed wedge reduces heartburn by allowing gravity to minimize reflux of stomach contents into the esophagus. Do not use pillows to prop yourself up; that only increases pressure on the stomach.
  • Prescription and over-the-counter medications. Along with lifestyle and diet changes, your doctor may recommend over-the-counter or prescription treatments.

Antacids can help neutralize acid in the esophagus and stomach and stop heartburn. Many people find that nonprescription antacids provide temporary or partial relief. Long-term use of antacids, however, can result in side effects including diarrhea, altered calcium metabolism (a change in the way the body breaks down and uses calcium), and buildup of magnesium in the body. Too much magnesium can be serious for patients with kidney disease. If antacids are needed for more than two weeks, a doctor should be consulted.

For chronic reflux and heartburn, your doctor may recommend prescription medications to reduce acid in the stomach. Some of these medicines are H2 blockers, which inhibit acid secretion in the stomach. H2 blockers include cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), and ranitidine (Zantac). Additionally, doctors may prescribe proton pump inhibitors, which also decrease the amount of acid produced in the stomach. Prilosec (omeprazole) and Nexium also are commonly used to promote healing of damage to the esophagus caused by stomach acid, but these medications are not for the immediate relief of heartburn.

We can’t always prevent acid reflux or hiatal hernia, but we can choose to moderate our diets and behaviors to produce more favorable results. It’s a new year – consider adding the reduction or elimination of heartburn to your 2017 wish list!

 


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Glaucoma Awareness

Glaucoma is a disease that damages your eye’s optic nerve. It usually occurs when fluid builds up in the front part of your eye which increases the pressure in your eye, damaging the optic nerve. It can lead to blindness if not treated.

January is Glaucoma Awareness Month. It’s estimated that over 2.2 million Americans have glaucoma, but only half of those know they have it. Glaucoma is the second-leading cause of blindness in the world, according to the World Health Organization, and after cataracts, is the leading cause of blindness among African Americans. In the United States, more than 120,000 people are blind from glaucoma, accounting for between nine percent and 12 percent of all cases of blindness.

Everyone is at risk for glaucoma, from babies to senior citizens. Older people are at a higher risk for glaucoma but babies can be born with glaucoma (approximately one out of every 10,000 babies born in the United States). Young adults can get glaucoma, too. African Americans in particular are susceptible at a younger age.

The most common types of glaucoma — primary open-angle glaucoma and angle-closure glaucoma — have completely different symptoms.

Primary open-angle glaucoma signs and symptoms include:

  • Gradual loss of peripheral vision, usually in both eyes
  • Tunnel vision in the advanced stages

Acute angle-closure glaucoma signs and symptoms include:

  • Eye pain
  • Nausea and vomiting (accompanying the severe eye pain)
  • Sudden onset of visual disturbance, often in low light
  • Blurred vision
  • Halos around lights
  • Reddening of the eye

Both open-angle and angle-closure glaucoma can be primary or secondary conditions. They’re called primary when the cause is unknown and secondary when the condition can be traced to a known cause such as eye injury, medications, certain eye conditions, inflammation, tumor, advanced cataract or diabetes. In secondary glaucoma, the signs and symptoms can include those of the primary condition as well as typical glaucoma symptoms.

When to see your doctor

Don’t wait for noticeable eye problems before seeing a doctor. Primary open-angle glaucoma gives few warning signs until permanent damage has already occurred. Regular eye exams are the key to detecting glaucoma early enough to successfully treat the condition and prevent further progression.

The American Academy of Ophthalmology recommends a comprehensive eye exam for all adults starting at age 40, and every three to five years after that if you don’t have any glaucoma risk factors. If you have other risk factors or you’re older than age 60, you should be screened every one to two years. If you’re African-American, your doctor likely will recommend periodic eye exams starting between ages 20 and 39.

In addition, a severe headache or pain in your eye, nausea, blurred vision, or halos around lights may be the symptoms of an acute angle-closure glaucoma attack. If you experience some or several of these symptoms together, seek immediate care at an emergency room or at an eye doctor’s (ophthalmologist’s) office right away.

Glaucoma is not curable, and vision lost cannot be regained. With medication and/or surgery, it is possible to halt further loss of vision. Since open-angle glaucoma is a chronic condition, it must be monitored for life. Diagnosis is the first step to preserving your vision – regular eye exams should be part of your personal wellness regimen, especially since there are a variety of other eye ailments that can afflict us. Through a regular eye exam, doctors can detect early warning signs for other diseases ranging from cancer to stroke.

 


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Get Active, Outdoors!

It’s time to pack away the guilt about how much we ate and how little we’ve exercised since November and get ourselves motivated to stay active this winter. Exercise and play are important for our physical and our mental health. Even though it’s colder and it still gets dark early, getting outdoors after work or school and on the weekends should be part of our wellness strategy. The fresh air is good for our lungs, the sun is good for our bodies (when we protect ourselves), and there are many interesting and healthy pursuits waiting outside our doors.

This season is rich in recreational opportunities that expand on the exercise and fitness we can be pursuing at the gym, in our homes, or at classes. Walking is the easiest example, whether in our neighborhood, at a local school or park. Jogging or hiking offers scenic beauty and interesting wintery landscapes as backdrop for our workout. Additionally, we live in a region that offers parks and forests for cross-country skiing, snow shoeing and snowmobiling, close-by mountains for downhill skiing, and frozen ponds or rinks for ice skating and hockey. And when the snow is abundant, so are opportunities for sledding, tubing and tobogganing, activities that are fun for the entire family and a good workout.

No matter the choice of outdoor recreational activity, it’s critical that we take appropriate measures to protect ourselves. That includes dressing for the weather, making sure we’re properly hydrated, wearing sunscreen, knowing our limitations, and always respecting Mother Nature.

Dressing in layers and wearing the right types of materials are critical for keeping warm in the cold weather. But when planning our outdoor wardrobe, moisture management is also an important consideration. To keep the body warm during high-energy activities, clothing should transport moisture away from the skin to the outer surface of the fabric where it can evaporate. Also, look for garments made from the new stretch fabrics for better fit and performance.

Cotton is a poor choice for insulation, because it absorbs moisture and loses any insulating value when it gets wet. Instead, moisture-wicking synthetics which move moisture away from the skin are the best choice for active winter sports like skiing, snowboarding, hiking or climbing. Not only do synthetic fabrics wick moisture away from the skin, they dry quickly and help keep us warm in the process.

The next layer should be a lightweight stretchy insulator, such as a breathable fleece sweater or vest. The final part of our cold-weather wear should be a lightweight and versatile shell jacket. Fabrics like three-layer Gore-Tex and Windstopper allow companies to create shells that are ultra lightweight while remaining waterproof, windproof, and breathable. For aerobic activities, a shell’s ventilating features are particularly important. Look for underarm zippers, venting pockets and back flaps.

Always bring a hat and gloves, regardless of the weather or activity. Proper foot protection is critical, as well — wear insulated and water-proof shoes or boots, and synthetic socks that won’t absorb sweat. As with the rest of our clothing, synthetic materials work best for protecting us against the extremes. Look for fleece hats made with Windstopper fabric, gloves and mittens layered with Gore-Tex and fleece, and socks made of synthetic, moisture-wicking materials.

No matter where we’re going or what we’re doing outdoors, bring plenty of water or sports drinks, and try to avoid caffeine or alcohol — both actually dry you out, instead of hydrating, and alcohol lowers our body temperature. Also, make sure to have a cell phone, that somebody knows where you are, and when you’ll be returning. And remember to apply a protective lip balm and to wear sunscreen — the sun’s ultraviolet rays remain potent, even in the winter, and hydrating our skin with a UV-protective moisturizer will help protect from wind and other elements.

Finally, though it may not be at the top of our “fun” list, when it snows most of us have to shovel. Dressing warmly and appropriately is key, and the same tips for hiking and sports apply:  Stretch before lifting, stay hydrated, and knows our limitations. Avoid alcohol, caffeine or nicotine before shoveling as these drugs place more strain on our body and on our heart. Use a shovel that isn’t too big to reduce weight, lift with our knees, not the back, and start slow and work steadily – take plenty of breaks, don’t rush and don’t try and lift too much at one time.

When it comes to winter activities in the outdoors, the best advice, overall, is to be smart and know our limitations. Many winter sports injuries happen at the end of the day, when people overexert themselves to finish that one last run or hike one more mile before the day’s end. A majority of these injuries can easily be prevented if participants prepare by keeping in good physical condition, stretch before getting started, stay alert and stop when tired or in pain. But the rewards are worth the risks – get out there, have fun, and stay healthy!


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Set Goals for a Healthier New Year

It’s not a coincidence that the gyms are packed in January — nor that the crowds thin in February. When it comes to our health and wellness, there’s also no denying our history, past successes, or lack of progress. Striking an effective balance between measurable action and good intentions is a challenge we all face in our personal and professional lives. But it’s not as simple as just labeling people action oriented or procrastinators — we’re all busy chasing kids, dogs, paychecks and as many other pressing details as there are hours in the day.

But now it’s a new year, a clean slate, tabula rasa. Coming off a season where many of us indulge by overeating, running around and pushing our bodies to unhealthy places, it is the perfect time to make specific plans, set goals and execute strategies that will truly help improve our health. Those plans should include diet, exercise and restful sleep, but the components that can have the most long-term value are how we make it easy to pursue health, and how we measure and reward ourselves and others for progress.

Employers can take an active role in encouraging and supporting their workers’ health and wellness efforts. There’s no question that the benefits of good health extend to productivity, quality, service and teamwork on the job. Employees who are healthier typically get sick less often, are more focused and rested. By establishing goals and working with your employees in positive ways, employers are directly affecting their bottom line.

Here are some simple tips for supporting health and wellness activities at work.

  • Offer healthcare screenings in the workplace. Many local healthcare service providers, clinics and insurers will come into offices to measure items such as cholesterol, blood pressure and body mass index. You also can arrange for flu-vaccination clinics, or address smoking-cessation, nutrition and other health and wellness initiatives.
  • Integrate the workplace in health-related activities. If employees are interested, establish a wellness committee and allow them to plan activities of interest to your workers. That could be inviting fitness or nutritional consultants to come speak during lunch or after work, bringing in yoga instructors, aerobic dance, fitness consultants or massage professionals. It also can include planning walks during the day, competitive sports after work, participating in charity events, and bringing healthy snacks, food and recipes into the office for sharing.
  • Set workplace-related goals. There’s power in sharing and collaboration. By setting team goals for weight loss, dietary changes, walking/exercise, smoking cessation and other commonly shared activities, employees can have fun, support one another, and think about health during the day. Offering simple rewards and incentives and publicly celebrating participation and successes builds teamwork and improves morale, as well.
  • Encourage healthcare education. Most large health benefits providers have extensive websites detailing healthcare actions, and offering guidance and useful information.
  • Join the CBIA Healthy Connections wellness program. This valuable program is available to all CBIA Health Connections participants at no additional charge.

We’re all responsible for our own health and wellness. Employers can’t mandate health, but they certainly can support efforts and encourage their workers. By discussing and supporting personal efforts, getting involved, facilitating planning and rewarding for participation, each of us can make 2017 a healthier year.